scholarly journals Comparision of Antibiotic Susceptility of Levofloxacin with Other Commonly Tested Antibiotics Against Salmonella Enterica Serovar (Typhi And Paratyphi A)

2014 ◽  
Vol 3 (1) ◽  
pp. 19-21
Author(s):  
A Chhetri ◽  
A Manandhar ◽  
Y Shah ◽  
RC Simkhada ◽  
R Paudyal ◽  
...  
Keyword(s):  
Nalidixic Acid ◽  
Salmonella Enterica ◽  
Antibiotic Susceptibility ◽  
Enteric Fever ◽  
Clinical Laboratory ◽  
Acid Resistance ◽  
Fluoroquinolone Resistance ◽  
Diffusion Method ◽  
Salmonella Enterica Serovar Typhi ◽  
Antibiotic Susceptibility Test

Background: Increasing antibiotic resistance of bacteria is a global problem. Fluoroquinolones are recommended as first line therapy for children and adults infected with Salmonella enterica serovar Typhi and Paratyphi A. The purpose of this study was to compare the antibiotic susceptibility pattern of different classes of antibiotics with levofloxacin from blood samples of suspected enteric fever patients visiting Birhospital, Kathmandu. Methods: Antibiotic susceptibility test was performed by Kirby-Bauerdisc diffusion method as per Clinical Laboratory Standards Institute guideline. Results: Among 50 isolates of Salmonella enterica, 39 (78%) were S.Typhi and 11 (22%) were S. Paratyphi A. All the isolates were tested against antibiotics, and all isolates were found sensitive to chloramphenicol and ceftriaxone whereas 3 isolates of S. Typhi were resistant to ciprofloxacin and 1 was resistant to levofloxacin. Fluoroquinolone resistant S. ParatyphiA was not observed. Among the 10 (20%) multi drug resistant isolates, only 1 isolate was resistant to levofloxacin which was S. Typhi. Both S.Typhi (96.7%) and S. Paratyphi A (89.4%) were resistant to Nalidixic acid. Conclusion: High level of nalidixic acid resistance and even some fluoroquinolone resistance showed that the treatment of the enteric fever cannot be relied on the fluoroquinolones. Nepal Journal of Medical Sciences | Volume 03 | Number 01 | January-June 2014 | Page 19-21 DOI: http://dx.doi.org/10.3126/njms.v3i1.10344

scholarly journals Nalidixic Acid Susceptibility Test for Screening Salmonella Isolates of Reduced Susceptibility/Higher Minimum Inhibitory Concentration to Ciprofloxacin

2015 ◽  
Vol 15 (2) ◽  
pp. 97-104 ◽  
Author(s):  
P. Agrawal ◽  
R. Tuladhar ◽  
N. Dahal
Keyword(s):  
Nalidixic Acid ◽  
Enteric Fever ◽  
Acid Resistance ◽  
Susceptibility Test ◽  
Diffusion Method ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Disc Diffusion ◽  
Antibiotic Susceptibility Test ◽  
Nalidixic Acid Resistance

Enteric fever is the major diagnosis among febrile patients in Nepal with yearly increase in nalidixic acid resistance and reduced ciprofloxacin susceptibility among Salmonella isolates. This study was carried out to evaluate the validity of nalidixic acid resistance as an indicator of reduced susceptibility of Salmonella isolates to ciprofloxacin. In this study, 999 blood specimens collected from suspected enteric fever patients visiting B&B Hospital were processed by standard microbiological techniques. Isolates were identified by biochemical tests and serotyping. Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method and CLSI recommended interpretive criteria. MIC of ciprofloxacin was determined by agar dilution method. Isolation rate of Salmonella species was 6.21%. Among 62 Salmonella isolates, 51 were S. typhi, 10 were S. paratyphi A and one isolate was S. paratyphi B. Only one isolate of S. typhi was multi-drug resistant. Resistance to ceftriaxone, cefixime and azithromycin was nil. On disc diffusion test, 55 isolates were resistant to nalidixic acid. Fifty-seven isolates were found to have increased (>0.125mg/ml) MIC of ciprofloxacin with the clinical and laboratory standards institute breakpoints. Nalidixic acid resistance showed a predictive value of 100% for ciprofloxacin resistance. Screening with nalidixic acid disc had a sensitivity of 100% and a specificity of 71.43% for the determination of decreased ciprofloxacin susceptibility. Before using ciprofloxacin for the treatment of enteric fever, appropriate identification of Salmonella isolates with reduced ciprofloxacin susceptibility is essential to limit the possible treatment failure and further development of highly resistant strains.DOI: http://dx.doi.org/njst.v15i2.12122Nepal Journal of Science and Technology Vol. 15, No.2 (2014) 97-104

ANTIMICROBIAL SUSCEPTIBILITY IN CULTURE POSITIVE ENTERIC FEVER

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. Manish Kulshrestha ◽  
Dr. Anjali Kulshrestha
Keyword(s):  
Bone Marrow ◽  
Blood Culture ◽  
Nalidixic Acid ◽  
Antimicrobial Susceptibility ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Multidrug Resistant ◽  
Bone Marrow Culture ◽  
Diffusion Method ◽  
Culture Positive

INTRODUCTION: Enteric fever includes typhoid and paratyphoid fever. Peak incidence is seen in children 5–15 years of age; but in regions where the disease is highly endemic, as in India, children younger than 5 years of age may have the highest infection rates. There are about 22 million new typhoid cases occur each year. Young children in poor, resource limited areas, who make up the majority of the new cases and there is a mortality figures of 215,000 deaths annually. A sharp decline in the rates of complications and mortality due to typhoid fever is observed as a result of introduction of effective antibiotic therapy since 1950s. MDR-ST became endemic in many areas of Asia, including India soon after multidrug-resistant strains of Salmonella enterica serotype typhi (MDR-ST) that were resistant to all the three first-line drugs then in use, namely chloramphenicol, amoxycillin and co-trimoxazole emerged in early 1990s. MATERIAL AND METHODS: Only blood culture or bone marrow culture positive cases were included. The patients with culture isolated enteric fever were included in the study. Antimicrobial susceptibility testing was carried out by disk diffusion method using antibiotic discs. The analysis of the antimicrobial susceptibility was carried out as per CLSI interpretative guidelines. RESULTS: A total of 82 culture positive cases were included in the present study. 80 culture isolates were from blood culture and 2 from the bone marrow culture. Salmonella entericasubspecies enterica serovartyphi (S typhi) was isolated from 67 (81.70%) patients while Salmonella enterica subspecies entericaserovarparatyphi (S paratyphi A) was isolated from 13 (15.85%) cases and 2 (2.44%) were Salmonella enterica subspecies entericaserovarschottmuelleri (S paratyphi B). Of the 82 cases 65(79.3%) isolates were resistant to ciprofloxacin, 17 (20.7%) were resistant to nalidixic acid, one (1.2%) case each was resistant to Cefotaxime and ceftriaxone, 2 (2.4%) were resistant to chloramphenicol, 10 (12.2%) were resistant and to cotrimoxazole 3 (3.7%) were resistant. CONCLUSION: In a culture positive cases 65(79.3%) isolates were resistant to ciprofloxacin and 17 (20.7%) were resistant to nalidixic acid. Multidrug resistant isolates were 65(79.3%).

scholarly journals Susceptibility to patterns of ciprofloxacin among nalidixic acid-resistant Salmonella isolates collected in Banepa, Nepal from enteric fever patients

2016 ◽  
Vol 89 (2) ◽  
Author(s):  
Girija Roka ◽  
Subash Pandaya ◽  
Md. Reyad-ul Ferdous ◽  
Manson Pandey ◽  
Naba Raj Pokhrel ◽  
...  
Keyword(s):  
Nalidixic Acid ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Inhibitory Concentration ◽  
Acid Resistance ◽  
Dilution Method ◽  
Disc Diffusion ◽  
Antimicrobial Sensitivity ◽  
Broth Dilution ◽  
Nalidixic Acid Resistance

The present study determined the susceptibility to ciprofloxacin of nalidixic acid resistant <em>Salmonella</em> (NARS) isolated from enteric fever patients at Scheer Memorial Hospital, Banepa, Nepal, from June 2012 to December 2012. The antimicrobial sensitivity to nalidixic acid and ciprofloxacin was determined using modified Kirby-Bauer disc diffusion and broth dilution method according to the guidelines of the Clinical and Laboratory Standard Institute. <em>Salmonella</em> was isolated from 34 out of 992 (3.43%) blood cultures collected during the study period, and 10 (29.4%) isolates were identified as <em>Salmonella enterica</em> serotype Typhi, while 24 (70.6%) were identified as <em>Salmonella enterica</em> serotype Paratyphi. Out of the total isolates, 31 (91.2%) were nalidixic acid-resistant <em>Salmonella</em> (NARS). Among NARS, the minimum inhibitory concentration values for ciprofloxacin ranged from 0.25 to 2 mg/L and were constantly higher than those shown by the nalidixic acid-susceptible <em>Salmonella</em>. Therefore, in typhoid <em>Salmonella</em> nalidixic acid resistance may be the indicator of decreased susceptibility to ciprofloxacin.

scholarly journals A study on Nalidixic Acid Resistant Salmonella among the patients attending Shree Birendra Hospital

2012 ◽  
Vol 10 (2) ◽  
pp. 1-3 ◽  
Author(s):  
Raina Chaudhary ◽  
Khagendra Sijapati ◽  
Sunil Kumar Singh
Keyword(s):  
Nalidixic Acid ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Brain Heart Infusion ◽  
Public Health Problem ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Diffusion Test ◽  
Sensitivity Pattern

Introduction: Enteric fever is the commonest public health problem in developing countries like Nepal. Multi Drug Resistant Salmonella isolates are in vitro susceptible to Quinolone but exhibited a higher Minimum Inhibitory Concentration in vivo. Such phenomenon can be demonstrated by simple disc diffusion test of Nalidixic Acid which shows resistance. This study is conducted to determine prevalence of Nalidixic Acid Resistant Salmonella with their anti biotic sensitivity pattern at Shree Birendra Hospital, Chauni, kathmandu. Method: Of total 3945 blood samples from the patients suspected to have enteric fever were collected during the period of January 2011 to August 2011. Then it was mixed with Brain Heart Infusion , further processed according to standard methodology and their anti microbial susceptibility was performed by Kirby-Bauer disc diffusion method. Results: From 3945 samples, 280 (7.09%) showed positi ve growth, 114 (40.7%) Salmonella enterica serotype Typhi and 166 (59.2%) Salmonella enterica serotype Paratyphi A. a total of 221 (78.92%) were Nalidixic Acid Resistant Salmonella, all these strains were sensitive to Ciprofloxcin and Ofloxacin in disc diffusion test. Conclusion: Study showed a higher frequency of Nalidixic Acid Resistant Salmonella among the patients. screening of Nalidixic Acid disc diffusion test must be done as routine work for determination of low level resistance of Quinolone so as to decide the drug for the treatment of enteric fever. DOI: http://dx.doi.org/10.3126/mjsbh.v10i2.6453 Medical Journal of Shree Birendra Hospital July-Dec 2011 10(2) 1-3

scholarly journals Antibiogram of Salmonella Spp Isolates in Kathmandu, Nepal

2018 ◽  
Vol 5 (2) ◽  
pp. 22-25 ◽  
Author(s):  
Damodar Gajurel ◽  
Rabi Prakash Sharma ◽  
Krishna Dhungana ◽  
Samir Neupane ◽  
Kamal Lamsal ◽  
...  
Keyword(s):  
Nalidixic Acid ◽  
Salmonella Enterica ◽  
Acid Resistance ◽  
Asian Countries ◽  
Medical Sciences ◽  
Salmonella Spp ◽  
Salmonella Enterica Serovar Typhi ◽  
October 17 ◽  
Culture Positive ◽  
Nalidixic Acid Resistance

INTRODUCTION: Drug resistant Salmonella spp. is endemic in several Asian countries. Nalidixic acid-resistant Salmonella enterica serovar Typhi and Salmonella enterica serovar Paratyphi A show reduced susceptibility to fluoroquinolones and have resulted in a rise in treatment failures. Over the past few decades, nalidixic acid-resistant Salmonella spp have emerged in Nepal as well.MATERIAL & METHODS: This is a retrospective study that aims to provide a more recent antibiogram of S. Typhi and S. Paratyphi A isolates in Kathmandu. Between Poush, 2071 and Ashwin, 2072 (December 16, 2014 to October 17, 2015), 186 culture positive cases of enteric fever were diagnosed at the Civil Service Hospital. Upon isolation of S. Typhi or S. Paratyphi A, antimicrobial susceptibility testing was performed with amoxicillin, azithromycin, ceftriaxone, chloramphenicol, ciprofloxacin, cotrimoxazole, nalidixic acid, ofloxacin and tetracyciline.RESULTS: This study shows a much higher frequency of nalidixic acid-resistance in Kathmandu than previously reported; 95.7% in Salmonella enterica serovar Paratyphi A and 86.5% in Salmonella enterica serovar Typhi.The rates of ciprofloxacinand ofloxacin-resistance were over 50% in both serovar.CONCLUSION: In Nepal, it is necessary to reevaluate the use of fluoroquinolone therapy and introduce feasible alternatives so as to curb treatment failures.Journal of Universal College of Medical Sciences (2017) Vol. 5, No, 2, Page: 22-25

scholarly journals Deteksi Resistensi Fluorokuinolon di Salmonella sp dengan Menggunakan Uji Kepekaan Asam Nalidiksat

2016 ◽  
Vol 18 (1) ◽  
pp. 30
Author(s):  
Lim Bing Tiam ◽  
Tjan Sian Hwa ◽  
Sri Mulyani ◽  
Widiyani Widiyani ◽  
Diyah Asmawati ◽  
...  
Keyword(s):  
Nalidixic Acid ◽  
First Generation ◽  
Acid Resistance ◽  
High Sensitivity ◽  
Generation Cephalosporin ◽  
Fluoroquinolone Resistance ◽  
Diffusion Method ◽  
First Line ◽  
Line Drug

Fluoroquinolone is used as first line drug for Salmonella sp infection, but there were reports of increasing treatment failure with fluoroquinolone in infection caused by Salmonella sp, which in vitro is still succeptible to fluoroquinolone. The identification of nalidixic acid resistance, a first generation quinolone provides a high sensitivity and specifity for the detection of such fluoroquinolone resistance. The researchers aim is to study the prevalence and the minimum ciprofloxacin inhibitory concentration of nalidixic acid resistant but fluoroquinolone sensitive Salmonella sp at Premier Jatinegara Hospital. Blood cultures sent to Premier Jatinegara Hospital Laboratory during 2010 were evaluated according to Clinical and Laboratory Standards Institute guidelines. Identification and MIC succeptibility testing were determined by VITEK® 2 Compact (Biomerieux®) and nalidixic acid succeptibility testing was performed by disc diffusion method according to Kirby Bauer. Thirty eight Salmonella sp isolates were identified, all were succeptible to ciprofloxacin (MIC  0,25 mg/L), but 5 (13,2%) isolates were resistant to nalidixic acid and reported as resistant. This study found that 13,2% of Salmonella sp were resistant to fluoroquinolone but not detected by the recommended CLSI breakpoint values. The researchers recommend that nalidixic acid testing be included in Salmonella sp succeptibility testing in Indonesia and consider 3rd generation cephalosporin as the first line drug before a succeptibility test result is available.

scholarly journals Antibiotic Susceptibility Pattern of Salmonella Enterica serovars Typhi and Paratyphi A Isolated From Patients Suspected of Enteric Fever

2020 ◽  
Vol 7 ◽  
pp. 31-36
Author(s):  
Dhirendra Niroula ◽  
Jyotsna Shrestha ◽  
Supriya Sharma ◽  
Anjana Singh
Keyword(s):  
Salmonella Enterica ◽  
Antibiotic Susceptibility ◽  
Enteric Fever ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Biochemical Tests ◽  
Salmonella Spp ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Microbiological Techniques

Objectives: The study aimed to assess the antibiotic susceptibility profile of Salmonella spp isolated from patients suspected of enteric fever. Methods: This cross-sectional prospective study was carried out from April to June, 2014among 484 patients clinically suspected of enteric fever visiting Bir Hospital, Kathmandu, Nepal. Blood sample collected from each patient was processed for culture in bile broth. Identification of Salmonella spp was done by conventional microbiological techniques including colony characteristics, Gram's staining and biochemical tests. Antibiotic susceptibility testing of identified isolates was done by Kirby-Bauer disk diffusion method following the 2014 CLS I guideline. Results: Out of 484 blood samples, 36 (7.43%) cases showed the growth of Salmonella spp; of which 27 (75%) were Salmonella enterica serovar Typhi (ST) and 9 (25%) were Salmonella enterica Paratyphi A (SPA). Among the Salmonella isolates, 5.55% were multidrug resistant and 41.66% were fluoroquinolone resistant. More than 80% of isolates were sensitive to chloramphenicol, amoxicillin, and cotrimoxazole whereas 58%, 50% and 6% of isolates were sensitive to fluoroquinolone antibiotics i.e. ciprofloxacin, ofloxacin and nalidixic acid respectively. All the isolates were susceptible to ceftazidime. All SPA and 89% of ST were sensitive to azithromycin. Conclusion: Higher percentage of susceptible isolates to chloramphenicol, cotrimoxazole, and amoxicillin suggests the reconsideration of these antibiotics for the treatment of enteric fever. Azithromycin can be considered as drug of choice for the treatment of enteric fever.  

scholarly journals Ciprofloxacin susceptibility of Salmonella enteric serovar Typhi and Paratyphi A from blood samples of suspected enteric fever patients

2012 ◽  
Vol 1 (1) ◽  
pp. 9-13 ◽  
Author(s):  
D Adhikari ◽  
D Acharya ◽  
P Shrestha ◽  
R Amatya
Keyword(s):  
Salmonella Enterica ◽  
Enteric Fever ◽  
Diffusion Method ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Disc Diffusion ◽  
Salmonella Spp ◽  
Blood Samples ◽  
Antibiotic Susceptibility Test

INTRODUCTION: Enteric fever caused by Salmonella enterica serovars Typhi and Paratyphi A is the common clinical diagnosis among febrile patients presenting to hospital in Nepal. The aim of this study was to evaluate the ciprofloxacin (CIP) and other antibiotics susceptibility patterns of Salmonella enterica serovars Typhi and Paratyphi A from blood samples of suspected enteric fever patients visiting KIST Medical College, Kathmandu. MATERIALS AND METHODS: Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method as per CLSI guidelines whereas MIC determination of ciprofloxacin was performed by agar dilution method. RESULTS: Altogether 64 presumptive Salmonella spp. were isolated from 840 blood samples of suspected enteric fever patients, of which 41 were S. Typhi and 23 were S. Paratyphi A. All Salmonella spp. isolates were sensitive to ceftriaxone and ofloxacin whereas 4 isolates were resistant to ciprofloxacin. One isolates each of S. Typhi and S. Paratyphi A were multidrug resistant. Fifty five isolates of Salmonella spp. were resistant to nalidixic acid (NA) with higher rate in S. Paratyphi A (91.3%) compared to S. Typhi (82.9%). MIC determination of ciprofloxacin revealed that majority of the isolates were resistant to ciprofloxacin and 2 isolates were resistant with MIC value of 4 µg/ml and 8 µg/ml. Importantly, we found simultaneous presence of NA resistance and decreased susceptibility to CIP suggesting that resistance to NA is a reliable indicator of decreased CIP susceptibility. CONCLUSIONS: Disc diffusion test failed to detect the reduced susceptibility of ciprofloxacin. Hence the MIC determination of ciprofloxacin against Salmonella spp. isolates would be important.  DOI: http://dx.doi.org/10.3126/ijim.v1i1.6938Int J Infect Microbiol 2012;1(1):9-13

scholarly journals Antimicrobial resistance among blood culture isolates of Salmonella enterica in New Delhi

2013 ◽  
Vol 7 (11) ◽  
pp. 788-795 ◽  
Author(s):  
Sarika Jain ◽  
Tulsi Das Chugh
Keyword(s):  
Antimicrobial Resistance ◽  
Nalidixic Acid ◽  
Antimicrobial Susceptibility ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Automated System ◽  
Diffusion Method ◽  
New Delhi ◽  
Third Generation ◽  
First Choice

Introduction: Enteric fever is a global public health problem, especially in developing countries. Antimicrobial resistance is a major issue enteric fever management. This study examined current pattern of antimicrobial susceptibility among Salmonella enterica isolates from enteric fever cases at a tertiary care centre in New Delhi, India. Methodology: Blood cultures from patients with enteric fever during January 2010- July 2012 were processed using the BACTEC automated system. Antimicrobial susceptibility was tested using Kirby Bauer’s disc diffusion method and/or Phoenix 100 automated system. Results: Of 344 isolates of Salmonella enterica, 266 (77.3%) were S. Typhi, 77 (22.4%) were S. Paratyphi A, and one (0.3%) was S. Paratyphi B. Resistance to nalidixic acid (NAR) (96.7%) was most common, followed by ciprofloxacin (37.9%), and azithromycin (7.3%). Multi-drug resistance was observed only in S. Typhi (3.4%). Among NAR strains, 61.8% were sensitive, 11.1% were moderately sensitive, and 23.9% were resistant to ciprofloxacin (0.8%, 57.4%, and 37.9% respectively according to revised CLSI breakpoint criteria for ciprofloxacin). Resistance to third-generation cephalosporin was found in seven (2%) strains of S. enterica. Conclusion: Increasing rates of nalidixic acid, fluoroquinolone and azithromycin resistance among S. enterica, particularly in S. Paratyphi A strains, is of concern, as S. Paratyphi A infection is becoming increasingly common and is not prevented by current vaccinations. Our results favour use of cefexime or possibly chloramphenicol as first choice for uncomplicated enteric fever. MICs for third-generation cephalosporins and susceptibility pattern must be closely monitored in view of its emerging resistance among Salmonella enterica.

scholarly journals Increased resistance to Nalidixic acid and Ciprofloxacin in Salmonella isolates from the Sub Himalayan region

2017 ◽  
Vol 5 (9) ◽  
pp. 4025
Author(s):  
Suruchi Bhagra ◽  
Atal Sood ◽  
DigVijay Singh ◽  
Anil Kanga
Keyword(s):  
Nalidixic Acid ◽  
Salmonella Enterica ◽  
Surrogate Marker ◽  
Acid Resistance ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Diffusion Technique ◽  
Global Concern ◽  
Ciprofloxacin Resistance

Background: During the last two decades, increased resistance to nalidixic acid and ciprofloxacin has become a cause of global concern. The present study was undertaken to ascertain nalidixic acid and ciprofloxacin resistance in Salmonella isolates from our region. To know the true pattern of ciprofloxacin resistance by determining the minimum inhibitory concentration (MIC) through E-test.Methods: All the Salmonella isolates recovered from blood cultures were screened for nalidixic acid resistance using 30µg disc by the Kirby Bauer disc diffusion method. Ciprofloxacin susceptibility was done both by disc diffusion and MIC using CLSI breakpoints.Results: We analysed a total of 80 Salmonella isolates during the last three years. Salmonella enterica serovar Typhi was the predominant serovar in 51 (64.8%) isolates, followed by Salmonella enterica serovar Paratyphi A comprising 28 (36.2%) isolates. Amongst the total isolates 78 (97.5%) were nalidixic acid resistant. Of these 54 (67.5%) showed intermediate susceptibility and 9 (11.2%) were ciprofloxacin resistant by the disc diffusion technique. On the contrary 29 (36.2%) had decreased susceptibility to ciprofloxacin; while a larger number 38 (47.5%) were detected resistant to ciprofloxacin on determination of MIC by the E-test.Conclusions: Screening for nalidixic acid acts as a surrogate marker to detect ciprofloxacin resistance. However, the true pattern of ciprofloxacin resistance can be determined by calculating the MIC by the E-test.

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